Holster for charging pectorally implanted medical devices

ABSTRACT

A system for recharging an implantable medical device. The system comprises a holster that may be donned in multiple respective configurations for charging implanted medical devices implanted at various locations within the patient&#39;s body. The system may further comprise a charging unit having an antenna on the patient&#39;s right side, a second configuration for charging a pectorally implanted medical device on the patient&#39;s left side, or a third configuration for use as a waist belt for charging a pectorally implanted medical device on either side of the patient.

This application is a continuation of U.S. patent application Ser. No.11/741,038 filed Apr. 27, 2007, which is a continuation-in-partapplication of U.S. patent application Ser. No. 11/414,155, filed Apr.28, 2006, now U.S. Pat. No. 7,738,965, both of which are incorporatedherein by reference in their entireties.

FIELD

The present disclosure relates to a holster for charging pectorallyimplanted medical devices.

BACKGROUND

Implantable medical devices for producing a therapeutic result in apatient are well known. An example of such an implantable medical deviceincludes implantable neurostimulators used for the treatment of movementdisorders such as Parkinson's Disease, essential tremor, and dystonia.Other examples of such implantable medical devices include implantabledrug infusion pumps, implantable cardioverters, implantable cardiacpacemakers, implantable defibrillators, and cochlear implants. Ofcourse, it is recognized that other implantable medical devices areenvisioned that utilize energy delivered or transferred from an externaldevice.

A common element in all of these implantable medical devices is the needfor electrical power in the implanted medical device. The implantedmedical device requires electrical power to perform its therapeuticfunction whether it be driving an electrical infusion pump, providing anelectrical neurostimulation pulse, or providing an electrical cardiacstimulation pulse. This electrical power is derived from a power source.

Typically, a power source for an implantable medical device can take oneof two forms. The first form utilizes an external power source thattranscutaneously delivers energy via wires or radio frequency energy.Having electrical wires that perforate the skin is disadvantageous due,in part, to the risk of infection. Further, continuously couplingpatients to an external power for therapy is, at least, a largeinconvenience. The second form utilizes single cell batteries as thesource of energy of the implantable medical device. This can beeffective for low power applications, such as pacing devices. However,such single cell batteries usually do not supply the lasting powerrequired to perform new therapies in newer implantable medical devices.In some cases, such as an implantable artificial heart, a single cellbattery might last the patient only a few hours. In other, less extremecases, a single cell unit might expel all or nearly all of its energy inless than a year. This is not desirable due to the need to explant andre-implant the implantable medical device or a portion of the device.One solution is for electrical power to be transcutaneously transferredthrough the use of inductive coupling. Such electrical power or energycan optionally be stored in a rechargeable battery. In this form, aninternal power source, such as a battery, can be used for directelectrical power to the implanted medical device. When the battery hasexpended, or nearly expended, its capacity, the battery can be rechargedtranscutaneously, via inductive coupling from an external power sourcetemporarily positioned on the surface of the skin. Several systems andmethods have been used for transcutaneously inductively recharging arechargeable battery used in an implantable medical device.

Transcutaneous energy transfer through the use of inductive couplinginvolves the placement of two coils positioned in close proximity toeach other on opposite sides of the cutaneous boundary. The internalcoil, or secondary coil, is part of or otherwise electrically associatedwith the implanted medical device. The external coil, or primary coil,is associated with the external power source or external charger orrecharger. The primary coil is driven with an alternating current. Acurrent is induced in the secondary coil through inductive coupling.This current can then be used to power the implanted medical device orto charge or recharge an internal power source or a combination of thetwo.

For implanted medical devices, the efficiency at which energy istranscutaneously transferred may be crucial. First, the inductivecoupling, while inductively inducing a current in the secondary coil,also has a tendency to heat surrounding components and tissue. Theamount of heating of surrounding tissue, if excessive, can bedeleterious. Since heating of surrounding tissue is limited, so also isthe amount of energy transfer that can be accomplished per unit time.The higher the efficiency of energy transfer, the more energy can betransferred while at the same time limiting the heating of surroundingcomponents and tissue. Second, it is desirable to limit the amount oftime required to achieve a desired charge, or recharge, of an internalpower source. While charging or recharging is occurring, the patientnecessarily has an external encumbrance attached to his or her body.This attachment may impair the patient's mobility and limit thepatient's comfort. The higher the efficiency of the energy transfersystem, the faster the desired charging or recharging can beaccomplished thus limiting any inconvenience to the patient. Third, theamount of charging or recharging can be limited by the amount of timerequired for charging or recharging. Since the patient is typicallyinconvenienced during such charging or recharging, there is a practicallimit on the amount of time during which charging or recharging shouldoccur. Hence, the size of the internal power source can be effectivelylimited by the amount of energy that can be transferred within theamount of charging time. The higher the efficiency of the energytransfer system, the greater amount of energy that can be transferredand, hence, the greater the practical size of the internal power source.This allows the use of implantable medical devices having higher poweruse requirements and providing greater therapeutic advantage to thepatient and/or extends the time between charging effectively increasingpatient comfort.

Implantable medical devices, external power sources, systems and methodshave not always provided the best possible system or method for allowingthe patient to be ambulatory during energy transfer and/or charging.Physical limitations related to the energy transfer and/or chargingapparatus and methods as well as necessary efficiencies of operation caneffectively limit the patient's ability to move around during suchenergy transfer and/or charging and can deleteriously affect patientcomfort.

SUMMARY

One aspect of the current disclosure provides a system totranscutaneously charge a power supply of an implantable device. Thesystem includes a charging unit, an antenna coupled to the charging unitand a strap. The strap comprises a shoulder strap portion adapted to besupported by a shoulder of the patient and a second strap portionadapted to encircle a portion of the patient. A cavity is carried by thestrap and, in one example, is positionable to a location proximate theimplantable device. The cavity is adapted to receive the antenna. In aparticular example, the second strap portion may be adapted to receivethe chest or waist of the patient. The shoulder strap portion may, inone instance, be removable. At least one of the shoulder strap portionand the second strap portion may be adjustable.

In another example, a system is provided that includes a charging unit,an antenna coupled to the charging unit, an implantable device adaptedto receive energy from the charging unit, and a strap. The strapcomprises a shoulder strap portion adapted to be supported by a shoulderof the patient. A cavity may be carried by the strap and may bepositionable to a location proximate the implantable device. The cavitymay be adapted to receive the antenna.

In yet a further example, a system is disclosed that comprises animplantable device adapted to be implanted in a patient. The systemfurther includes a charging unit, an antenna coupled to charging unit,and a strap adapted to be supported by a portion of the patient's body.The strap comprises a cavity adapted to carry the antenna to allow theantenna to transcutaneously provide energy to the implantable device. Inone particular embodiment, the cavity is positionable relative to theimplantable device.

Other examples and aspects are described by the drawings and theaccompanying description.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates an implantable medical device implanted in a patient;

FIG. 2 is a schematic cross-sectional side view of an external antennaand an implanted medical device implanted in a patient;

FIG. 3 is a front perspective view of a holster for charging apectorally implanted medical device on a patient's right side;

FIG. 4 is a front perspective view of the holster shown in FIG. 3 forcharging a pectorally implanted medical device on a patient's left side;

FIG. 5 is a front perspective view of a portion of the holster shown inFIG. 3 for charging a pectorally implanted medical device;

FIG. 6 is a front view of an external antenna operatively connected to arear panel of an antenna holder of the holster shown in FIG. 3;

FIG. 7 is a front perspective view of a rear panel and a front panel ofan antenna holder of the holster shown in FIG. 3;

FIG. 8 is a front perspective view of the holster shown in FIG. 3 with afront panel of an antenna holder removed and an access panel of arechargeable power source in an open position;

FIG. 9 is a front perspective view of another embodiment holsterconstructed according to the principles of the present disclosure;

FIG. 10 is a front perspective view of an antenna holder of the holstershown in

FIG. 9 with a front panel in an open position;

FIG. 11 illustrates a patient donning the holster shown in FIG. 3 on thepatient's left side;

FIG. 12 illustrates a patient donning the holster shown in FIG. 3 on thepatient's right side;

FIG. 13 is a front view of a connector;

FIG. 14 is a front perspective view of the connector shown in FIG. 13operatively connected to a strap;

FIG. 15 is a rear perspective view of the connector shown in FIG. 13operatively connected to a strap;

FIG. 16 is a front view of a front panel of the holster shown in FIG. 3;

FIG. 17 is a front perspective view of a rechargeable power sourceholder of the holster shown in FIG. 3;

FIG. 18 is a rear perspective view of the rechargeable power sourceholder shown in FIG. 17;

FIG. 19 is a front perspective view of another embodiment holsterconstructed according to the principles of the present disclosure;

FIG. 20 is a perspective view of a recharging system including acharging unit holder, a charging unit, an antenna, and anotherembodiment holster constructed according to the principles of thepresent disclosure;

FIG. 21 is a front view of the holster shown in FIG. 20;

FIG. 22 is a front perspective view of a portion of the holster shown inFIG. 20 illustrating connection of an antenna holder to a torso strap ofthe holster;

FIG. 23 is a front perspective view of a portion of the holster shown inFIG. 20 illustrating how a patient inserts the patient's right arm intoan opening of a loop formed by the holster connected as shown in FIG.22;

FIG. 24 is a front perspective view illustrating how the patient placesthe holster shown in FIG. 20 on the patient's right shoulder;

FIG. 25 is a front perspective view illustrating how the patientconnects the torso strap of the holster shown in FIG. 20 about thepatient's torso;

FIG. 26 is a front perspective view illustrating how the patient adjuststhe torso strap of the holster shown in FIG. 20 about the patient'storso;

FIG. 27 is a front perspective view illustrating how the patient insertsthe antenna into the antenna holder of the holster shown in FIG. 20;

FIG. 28 is a front perspective view of the patient donning the holstershown in FIG. 20 on the patient's right side;

FIG. 29 is a front perspective view of the patient donning the holstershown in FIG. 20 on the patient's left side;

FIG. 30 is a front perspective view of the charging unit holder shown inFIG. 20;

FIG. 31 is a rear view of the charging unit holder shown in FIG. 30; and

FIG. 32 is a side view of a clip of the charging unit holder shown inFIG. 31.

DETAILED DESCRIPTION OF A PREFERRED EMBODIMENT

A preferred embodiment holster for charging pectorally implanted medicaldevices constructed according to the principles of the presentdisclosure is designated by the numeral 115 in the drawings, anotherembodiment holster for charging pectorally implanted medical devicesconstructed according to the principles of the present disclosure isdesignated by the numeral 215 in the drawings, another embodimentholster for charging pectorally implanted medical devices constructedaccording to the principles of the present disclosure is designated bythe numeral 315 in the drawings, and another embodiment holster forcharging pectorally implanted medical devices constructed according tothe principles of the present disclosure is designated by the numeral415 in the drawings.

The holsters 115, 215, 315, and 415 may be used to charge any suitablepectorally implanted medical device. The term “charge” refers to anytype of charge including, but not limited to, an initial charge and arecharge. The pectoral region is preferably proximate the pectoralmuscles and is more preferably within a region of the body below theclavicle, above the xiphoid process of the sternum, and between thesternum and the axilla, which is a cavity beneath the junction of thearm and the torso. An example of a suitable pectorally implanted medicaldevice for use with the present disclosure is disclosed in U.S. PatentPublication No. US 2005/0245996 A1, published Nov. 3, 2005, entitledSpacers for Use with Transcutaneous Energy Transfer System.

FIG. 1 shows a pectorally implanted medical device 103, for example aneurostimulator used for the treatment of a movement disorder such asParkinson's Disease, essential tremor, and dystonia, implanted in thepectoral region of a patient 100. The pectorally implanted medicaldevice 103 is typically implanted by a surgeon in a sterile surgicalprocedure performed under local, regional, or general anesthesia. Duringthe sterile surgical procedure, a catheter 102 is typically implantedwith the distal end position at a desired therapeutic delivery site 101and the proximal end tunneled under the skin to the location where thepectorally implanted medical device 103 is to be implanted. Thepectorally implanted medical device 103 is then implanted. Once thepectorally implanted medical device 103 is implanted into the patient100, the incision can be sutured closed and pectorally implanted medicaldevice 103 can begin operation. The pectorally implanted medical device103 can be any suitable implantable medical device such as, but notlimited to, implantable neurostimulators, implantable drug infusionpumps, implantable cardioverters, implantable cardiac pacemakers,implantable defibrillators, and cochlear implants.

The pectorally implanted medical device 103 includes a rechargeablepower source that can be charged while the pectorally implanted medicaldevice 103 is implanted in a patient through the use of an externalcharging device, which is a power source, comprising an external antenna107 and a charging unit 109. The charging unit 109 may also be referredto as a recharger. The charging unit 109 contains the electronicsnecessary to drive a primary coil in the antenna 107 with an oscillatingcurrent in order to induce a current in a secondary coil in thepectorally implanted medical device 103 when the primary coil in theantenna 107 is placed in proximity of the secondary coil in thepectorally implanted medical device 103. The charging unit 109 ispreferably operatively coupled to the primary coil in the antenna 107 bycable 108. Suitable charging units include without limitation thosedescribed in U.S. Patent Publication Nos. 2005/0113887; 2005/0075700;2005/0075699; 2005/0075698; 2005/0075697; 2005/0075696; 2005/0075694;and 2005/0075693; all of which are incorporated herein by reference. Itis also recognized that the charging unit 109 and the antenna 107 may becontained in a common housing rather than in separate housings.

The pectorally implanted medical device 103, when implanted, usuallyleaves an area of the patient's body that is not quite as flat as it wasbefore implantation. That is, the pectorally implanted medical device103 usually leaves a bulging area 106 proximate the surface of thepatient's skin which bulges outward somewhat to accommodate the bulk ofthe pectorally implanted medical device 103. It is typically relativelyeasy for the patient, the medical professional, or another person toplace the antenna 107 in the general area of the pectorally implantedmedical device 103 and move the antenna 107 around until the antenna 107is relatively centered with the bulging area 106. Once the antenna 107is positioned in this manner, the antenna 107 can be secured to thepatient's body.

As shown in FIG. 2, a schematic cross-sectional side view of an antenna107 and a pectorally implanted medical device 103 implantedsubcutaneously in the pectoral region of a patient, the pectorallyimplanted medical device 103 is implanted in a patient under cutaneousboundary 105 creating bulging area 106, an area of the patient's body inwhich the patient's skin is caused to bulge slightly due to theimplantation of the pectorally implanted medical device 103. Bulgingarea 106 is an aid to locating the position of the secondary coil in thepectorally implanted medical device 103 and the antenna 107 can bepositioned proximate the area where the pectorally implanted medicaldevice 103 is implanted.

The antenna 107 is placed over the bulging area 106 as a power source tocharge the pectorally implanted medical device 103. Depending upon theapplication and the pectorally implanted medical device 103, thepectorally implanted medical device 103 is generally implantedsubcutaneously at depths of from 1 centimeter (0.4 inches) to 2.5centimeters (1 inch) where there is sufficient tissue to support theimplanted system. However, the locations of the implantation vary frompatient to patient. The amount of bone and the amount of soft tissuebetween the bone and the cutaneous boundary 105 are factors that affectthe actual depth of implant. The actual depth of implant as well as theamount of soft tissue at, and around, the implant site affect the sizeand shape of bulging area 106 at the implant site. Further, the locationof the pectorally implanted medical device may vary in the patient dueto any movement of the pectorally implanted medical device, especiallyif the pectorally implanted medical device is not sutured into place,any weight loss or gain, or any loss or gain of muscle mass.

This type of a transcutaneous energy transfer system can be utilizedover extended periods of time, either to power the pectorally implantedmedical device 103 over an extended period of time or to charge areplenishable power supply within the pectorally implanted medicaldevice 103. Depending upon the capacity of the replenishable powersupply and the efficiency of the energy transfer, the charging unit 109and the antenna 107 can be utilized for hours. Further, over theextended period of time in which the charging unit 109 is utilized,antenna 107 is affixed to the patient's body. As the patient attempts tocontinue a normal routine, such as by making normal movement or bysleeping, during the energy transfer, it may be difficult to maintainthe antenna 107 in a fixed position relative to the secondary coil inthe pectorally implanted medical device 103. Movement of the antenna 107with respect to the secondary coil can result in a change in mutualinductance, L_(mutual), a change in impedance, and a change in theresonant frequency, f_(resonate). Further, any change in spatialpositioning of the energy transfer system with any external conductiveobject, any change in the characteristics of the antenna 107, such as byfractures in the magnetic core, for example, a change in the chargelevel of the rechargeable power source of the pectorally implantedmedical device 103 or a change in the power level of the charging unit109, all of which can result in a change of mutual inductance,L_(mutual).

The pectoral region of the patient is typically not a flat surface sothe antenna 107 may not sit completely flat against the patient's skin.This may be especially true as the patient moves and the pectoral regionmoves during such movement. Therefore, it is preferred that the holster115, the holster 215, the holster 315, and the holster 415 be conformaland flexible in order to conform to the shape of the patient's pectoralregion.

As shown in FIGS. 3, 4, and 8, the holster 115 includes an antennaholder 116, a shoulder strap 135, a chest strap 152, and a charging unitholder 160. The antenna holder 116 includes a first panel 117 and asecond panel 119 forming a cavity 134 therebetween configured andarranged to house an antenna 107. The first panel 117 preferablyincludes a rectangular base portion 117 a with a truncated triangularportion 117 b having concave sides extending upward from the rectangularbase portion 117 a. The first panel 117 has a top portion 125 proximatethe top of the truncated triangular portion 117 b and a left portion 126and a right portion 127 proximate opposing sides of the rectangular baseportion 117 a. The second panel 119 preferably also includes arectangular base portion 119 a with a truncated triangular portion 119 bhaving concave sides extending upward from the rectangular base portion119 b. The second panel 119 has a top portion 128 proximate the top ofthe truncated triangular portion 119 b and a left portion 129 and aright portion 130 proximate opposing sides of the rectangular baseportion 119 a. The first panel 117 is the inner layer proximate thepatient's skin and the second panel 119 is the outer layer. The firstpanel 117 and the second panel 119 are approximately the same size andinclude corresponding circular openings 118 and 120, respectively, withthe opening 120 preferably being slightly larger in diameter than theopening 118. The opening 118 allows the antenna 107 to contact thepatient's skin, and the opening 120 provides access to the antenna 107.

Stitching is preferably used to connect the first panel 117 and thesecond panel 119 together and to hold the antenna 107 in place withinthe cavity 134. FIGS. 6, 7, and 16 show the preferred stitchingpatterns. Stitching 121 partially encircles openings 118 and 120proximate the perimeter of the antenna 107 leaving a gap 121 a proximatethe top of the openings 118 and 120 to allow the cable 108 to extendupward therethrough as shown in FIG. 6. Stitching 121 holds the antenna107 in place within the cavity 134 so that the antenna 107 is accessiblethrough the openings 118 and 120. Stitching 122 may be used to securethe cable 108 to the first panel 177 in an upward orientation relativeto the antenna holder 116. Stitching 131 is preferably used to securethe first panel 117 and the second panel 119 closed proximate thebottoms of the rectangular portions 117 a and 119 a and the sides of thetruncated triangular portions 117 b and 119 b. A fastener (not shown)such as hook and loop may be connected to the outer surface of the topportion 125 and to the inner surface of the top portion 128 so that thetop portions 125 and 128 are releasably connectable to allow access tothe cavity 134. As shown in FIG. 16 for the second panel 119, stitching137 may be used to finish the edge of the second panel 119 and stitching137 and 139 may be used to secure the fastener to the top portion 128 ofthe second panel 119. The stitching patterns shown in FIG. 16 for thesecond panel 119 may also be used for the first panel 117. In addition,stitching 124 connects buckle portions 132 and 133 to the left portion126 and the right portion 127, respectively, of the first panel 117 andstitching 123 connects a first end 135 a of a shoulder strap 135 to thetop portion 125 of the first panel 117. Because the left portions 126and 129 and the right portions 127 and 120 are not stitched together,the buckle portions 132 and 133 are accessible between the first andsecond panels 117 and 119.

The shoulder strap 135 includes the first end 135 a, a second end 135 b,and an intermediate portion 135 c between the first end 135 a and thesecond end 135 b. The first end 135 a is connected to the top portion125 of the first panel 117, and the second end 135 b is connected to amiddle bar portion 165 of an adjuster 153. The intermediate portion 135c of the shoulder strap 135 is routed through slots 166 and 167 of theadjuster 153 and through a slot 148 a of a connector 148, which connectsthe intermediate portion 135 c to a junction 140. FIGS. 13-15 illustratehow the shoulder strap 135 is connected to the adjuster 153. To adjustthe length of the shoulder strap 135, the adjuster 153 and the secondend 135 b may be moved along the length of the intermediate portion 135c by sliding the intermediate portion 135 c through the slots 166, 167,and 148 a. The adjuster 153 preferably does not come into contact withthe patient's skin to aid in the comfort of the holster 115.

The junction 140 is preferably an upside down T-shaped memberinterconnecting the shoulder strap 135 and the chest strap 152 andincluding a top portion 141 and a bottom portion 147. An opening 150 isformed between the shoulder strap 135 and the chest strap 152 throughwhich the patient's arm is inserted to don the holster 115. Theconnector 148 interconnects the shoulder strap 135 and the top portion141. The bottom portion 147 includes a left portion 142, a right portion143, and a channel 146 extending through the bottom portion 147. Thechannel 146 is preferably wide enough to accommodate the chest strap 152and slide the chest strap 152, including an adjuster 153, therethrough.Within the channel 146 are two fasteners 149 proximate the left andright portions 142 and 143.

The chest strap 152 includes a first end 152 a, a second end 152 b, andan intermediate portion 152 c between the first end 152 a and the secondend 152 b. The first end 152 a is connected to a buckle portion 154 andthe second end 152 b is connected to an adjuster 153 in a similar manneras the second end 135 b of the shoulder strap 135 is connected to anadjuster 153. The intermediate portion 152 c is routed through slots 166and 167 of the adjuster 153 and through a slot (not shown) of a buckleportion 157. To adjust the length of the chest strap 152, the adjuster153 and the second end 152 b may be moved along the length of theintermediate portion 152 c by sliding the intermediate portion 152 cthrough the slots 166 and 167 and through the slot in the buckle portion157. The intermediate portion 152 c includes a position indicator 145proximate a left portion of the chest strap 152, as shown in FIG. 3, anda position indicator 156 proximate a right portion of the chest strap152, as shown in FIG. 4. A mating fastener 144 is located on each sideof the position indicator 145, and a mating fastener 155 is located oneach side of the position indicator 156. The mating fasteners 144 and155 are each configured and arranged to mate with the fasteners 149within the channel 146 of the junction 140 to secure the chest strap 152to the junction 140.

As shown in FIGS. 17 and 18, the charging unit holder 160 includes sides173 and a top 174 interconnecting a front 170 and a back 171 to form acavity 164 therebetween. A zipper 175 in the top 174 provides access tothe cavity 164 in which the charging unit 109 is housed. The front 170includes an access panel 161, which may be opened, as shown in FIG. 8,to reveal the charging unit 109. A strap 172 is connected to the back171 and a buckle portion 162 is connected to one end and a buckleportion 163 is connected to the other end proximate opposing sides ofthe charging unit holder 160.

The holster 115 is versatile as it may be donned in a firstconfiguration on the patient's right side as illustrated in FIGS. 3 and12, in a second configuration on the patient's left side as illustratedin FIGS. 4 and 11, or in a third configuration as a waist belt asillustrated in FIG. 5. The buckle portions 133, 157, and 162 arepreferably male buckle portions, and the buckle portions 132, 154, and163 are preferably female mating buckle portions. The male buckleportions are releasably connectable to the female buckle portions. Thisenables the charging unit holder 160 to be positioned on either side ofthe antenna holder 116 or to be used with the chest strap 152 as a waistbelt. Alternatively, the charging unit holder 160 could be eliminatedfrom the holster 115.

For a pectorally implanted medical device in the patient's rightpectoral region, the buckle portion 162 of the charging unit holder 160is connected to the buckle portion 132 of the antenna holder 116, andthe buckle portion 133 of the antenna holder 116 is connected to thebuckle portion 154 of the chest strap 152. These connections arepreferably hidden from view between the first and second panels 117 and119 of the antenna holder 116. The buckle portion 163 of the chargingunit holder 160 is connected to the buckle portion 157 of the cheststrap 152 and serves as the main buckle the patient uses to secure andrelease the holster 115. Once the holster 115 has been adjusted to fitthe patient, only the main buckle needs to be secured and released todon the holster 115 and the other buckle portions can remain secured.The fasteners 155 of the chest strap 152 are connected to the fasteners149 of the junction 140 and the position indicator 145 providesindication that the longer portion of the chest strap 152 should bepositioned proximate the patient's left side thereby positioning theantenna holder 116 proximate the patient's right side.

For a pectorally implanted medical device in the patient's left pectoralregion, the buckle portion 163 of the charging unit holder 160 isconnected to the buckle portion 133 of the antenna holder 116, and thebuckle portion 132 of the antenna holder 116 is connected to the buckleportion 157 of the chest strap 152. These connections are preferablyhidden from view between the first and second panels 117 and 119 of theantenna holder 116. The buckle portion 162 of the charging unit holder160 is connected to the buckle portion 154 of the chest strap 152 andserves as the main buckle the patient uses to secure and release theholster 115. Once the holster 115 has been adjusted to fit the patient,only the main buckle needs to be secured and released to don the holster115 and the other buckle portions can remain secured. The fasteners 144of the chest strap 152 are connected to the fasteners 149 of thejunction 140 and the position indicator 156 provides indication that thelonger portion of the chest strap 152 should be positioned proximate thepatient's right side thereby positioning the antenna holder 116proximate the patient's left side.

Alternatively, the charging unit holder 160 could be eliminated from theholster 115 and the buckle portion 154 could be connected to the buckleportion 127 and the buckle portion 132 could be connected to the buckleportion 157.

For use as a waist belt, the antenna holder 116, the shoulder strap 135,and the junction 140 are removed from the holster 115 leaving the cheststrap 152 and the charging unit holder 160. Preferably, the buckleportion 163 of the charging unit holder 160 is connected to the buckleportion 157 of the chest strap 152 and the buckle portion 162 of thecharging unit holder 160 is connected to the buckle portion 154 of thechest strap 152. The antenna 107 is then either manually held proximatethe pectorally implanted medical device 103 or held by other suitablemeans known in the art.

Regardless how the holster 115 is donned by the patient, the antenna 107is placed within the cavity 134 and the openings 118 and 120 of theantenna holder 116 and the charging unit 109 is placed within the cavity164 of the charging unit holder 160. The cable 108 interconnects theantenna 107 and the charging unit 109, and any excess cable 108 may bestored within the cavity 134 of the antenna holder 116. In FIG. 8, thecharging unit 109 is shown operatively connected to a cable 110 whichoperatively connects the charging unit 109 to a power source such as awall outlet. The cable 110 is preferably only used when the chargingunit 109 is being charged and may be removed to allow the patient to beambulatory during charging of the pectorally implanted medical device.

To don the holster 115, it is first determined on which side of thepatient the pectorally implanted medical device is located, and then theholster 115 is configured accordingly. Then, the patient inserts thepatient's arm through the shoulder strap 135 and through the opening 150between the shoulder strap 135 and the chest strap 152. After thepectorally implanted medical device 103 has been located, the antenna107 is then placed proximate the pectorally implanted medical device103. For a pectorally implanted medical device on the patient's rightside, the main buckle is the connection between the buckle portion 163of the charging unit holder 160 and the buckle portion 157 of the cheststrap 152 and serves as the main buckle the patient uses to secure andrelease the holster 115. For a pectorally implanted medical device onthe patient's left side, the main buckle is the connection between thebuckle portion 162 of the charging unit holder 160 and the buckleportion 154 of the chest strap 152 and serves as the main buckle thepatient uses to secure and release the holster 115. The shoulder strap135 and the chest strap 152 may be adjusted using the adjusters 153 asneeded to ensure that the antenna 107 is proximate the pectorallyimplanted medical device 103. For a shorter charge time of thepectorally implanted medical device 103, the center of the antenna 107should be placed over the center of the pectorally implanted medicaldevice 103. The antenna 107 should not be moved around or the chargetime could be increased. Also, the less tissue there is between thepectorally implanted medical device 103 and the antenna 107, the shorterthe charge time will be.

Another embodiment holster 215 is shown in FIG. 9. The holster 215includes an antenna holder 216, a shoulder strap 235, a left chest strap252, a right chest strap 268, and a charging unit holder 260. Theantenna holder 216 includes a first panel 217 and a second panel 219forming a cavity 234 therebetween configured and arranged to house anantenna 107. The first panel 217 and the second panel 219 are similarlyconstructed. The first panel 217 preferably includes a rectangular baseportion 217 a with a truncated triangular portion 217 b having concavesides extending upward from the rectangular base portion 217 a. Thefirst panel 217 has a top portion 225 proximate the top of the truncatedtriangular portion 217 b and a left portion 226 and a right portion 227proximate opposing sides of the rectangular base portion 217 a. Thesecond panel 219 also includes a rectangular base portion 219 a with atruncated triangular portion 219 b having concave sides extending upwardfrom the rectangular base portion 219 b. The second panel 219 has a topportion 228 proximate the top of the truncated triangular portion 219 band a left portion 229 and a right portion 230 proximate opposing sidesof the rectangular base portion 219 a. The first panel 217 is the innerlayer proximate the patient's skin and the second panel 219 is the outerlayer. The first panel 217 and the second panel 219 are approximatelythe same size and include corresponding circular openings (not shown)with the opening in the second panel 219 preferably being slightlylarger in diameter than the opening in the first panel 217. The openingin the first panel 217 allows the antenna 107 to contact the patient'sskin, and the opening in the second panel 219 provides access to theantenna 107. Stitching (not shown) is preferably used to connect thefirst panel 217 and the second panel 219 together and to hold theantenna 107 in place within the cavity 234. In addition, a fastener (notshown) such as hook and loop may be connected to the outer surface ofthe top portion 225 and to the inner surface of the top portion 228 sothat the top portions 225 and 228 are releasably connectable to allowaccess to the cavity 234.

The shoulder strap 235 includes a first end 235 a, a second end 235 b,and an intermediate portion 235 c between the first end 235 a and thesecond end 235 b. The first end 235 a is connected to a top portion 241of a junction 240 and the second end 235 b is connected to an adjuster253. The intermediate portion 235 c of the shoulder strap 235 is routedthrough slots in the adjuster 253 and through a slot of a connector 274,which connects the intermediate portion 235 c to the top portions 225and 228 of the antenna holder 216. To adjust the length of the shoulderstrap 235, the adjuster 253 and the second end 235 b may be moved alongthe length of the intermediate portion 235 c by sliding the intermediateportion 235 c through the slots in the adjuster 253 and the connector274. The adjuster 253 preferably does not come into contact with thepatient's skin to aid in the comfort of the holster 215.

The junction 240 is preferably an upside down T-shaped memberinterconnecting the shoulder strap 235 and the left and right cheststraps 252 and 268 and including a top portion 241 and a bottom portion247. As shown in FIG. 9, an opening 250 is formed between the shoulderstrap 235 and the chest strap 252 through which the patient's arm isinserted to don the holster 215 for a pectorally implanted medicaldevice on the patient's right side. The bottom portion 247 includes aleft portion 242 connected to a connector 255 and a right portion 243connected to a connector 270.

The left chest strap 252 includes a first end 252 a, a second end 252 b,and an intermediate portion 252 c between the first end 252 a and thesecond end 252 b. The first end 252 a is connected to the connector 255and the second end 252 b is connected to an adjuster 253 in a similarmanner as the second end 235 b of the shoulder strap 235 is connected toan adjuster 253. The intermediate portion 252 c is routed through slots(not shown) in the adjuster 253 and through a slot (not shown) of abuckle portion 257. To adjust the length of the left chest strap 252,the adjuster 253 and the second end 252 b may be moved along the lengthof the intermediate portion 252 c by sliding the intermediate portion252 c through the slots in the adjuster 253 and the buckle portion 257.

The right chest strap 268 includes a first end 268 a, a second end 268b, and an intermediate portion 268 c between the first end 268 a and thesecond end 268 b. The first end 268 a is connected to the connector 270and the second end is connected to an adjuster 253 in a similar manneras the second end 235 b of the shoulder strap 235 is connected to anadjuster 253. The intermediate portion 268 c is routed through slots(not shown) in the adjuster 253 and through a slot (not shown) of abuckle portion 254. To adjust the length of the right chest strap 268,the adjuster 253 and the second end 268 b may be moved along the lengthof the intermediate portion 268 c by sliding the intermediate portion268 c through the slots in the adjuster 253 and the buckle portion 254.

The charging unit holder 260 is preferably rectangular in shape andincludes an access panel 261 which may be opened to reveal the chargingunit housed therein. A buckle portion 263 is connected to the left endand a buckle portion 262 is connected to the right end of the chargingunit holder 260.

FIG. 10 shows the top portion 228 peeled away from the top portion 225to expose the cable 108, the left portion 229 peeled away from the leftportion 226 to expose the buckle portion 232, and the right portion 230peeled away from the right portion 227 to expose the buckle portion 254.

The holster 215 is versatile as it may be donned in a firstconfiguration on the patient's right side as illustrated in FIG. 9 or ina second configuration on the patient's left side (not shown). Thebuckle portions 233, 257, and 262 are preferably male buckle portions,and the buckle portions 232, 254, and 263 are preferably female matingbuckle portions. The male buckle portions are releasably connectable tothe female buckle portions. This enables the charging unit holder 260 tobe positioned on either side of the antenna holder 216 for donning oneither the right or the left side of the patient. Alternatively, thecharging unit holder 260 could be eliminated from the holster 215.

For a pectorally implanted medical device in the patient's rightpectoral region, the buckle portion 262 of the charging unit holder 260is connected to the buckle portion 232 of the antenna holder 216, andthe buckle portion 233 of the antenna holder 216 is connected to thebuckle portion 254 of the right chest strap 268. These connections arepreferably hidden from view between the first and second panels 217 and219 of the antenna holder 216. The buckle portion 263 of the chargingunit holder 260 is connected to the buckle portion 257 of the left cheststrap 252 and serves as the main buckle the patient uses to secure andrelease the holster 215. Once the holster 215 has been adjusted to fitthe patient, only the main buckle needs to be secured and released todon the holster 215 and the other buckle portions can remain secured.

For a pectorally implanted medical device in the patient's left pectoralregion, which is not shown, the buckle portion 263 of the charging unitholder 260 is connected to the buckle portion 233 of the antenna holder216, and the buckle portion 232 of the antenna holder 216 is connectedto the buckle portion 257 of the left chest strap 252. These connectionsare preferably hidden from view between the first and second panels 217and 219 of the antenna holder 216. The buckle portion 262 of thecharging unit holder 260 is connected to the buckle portion 254 of theright chest strap 268 and serves as the main buckle the patient uses tosecure and release the holster 215. Once the holster 215 has beenadjusted to fit the patient, only the main buckle needs to be securedand released to don the holster 215 and the other buckle portions canremain secured.

Alternatively, the charging unit holder 260 could be eliminated from theholster 215 and the buckle portion 254 could be connected to the buckleportion 227 and the buckle portion 232 could be connected to the buckleportion 257. Alternatively, the antenna holder 216 and the shoulderstrap 235 could be eliminated from the holster 215 and used as a waistbelt.

To don the holster 215, it is first determined on which side of thepatient the pectorally implanted medical device is located, and then theholster 215 is configured accordingly. Then, the patient inserts thepatient's arm through the shoulder strap 235 and through the opening 250between the shoulder strap 235 and either the left chest strap 252 orthe right chest strap 268. After the pectorally implanted medical devicehas been located, the antenna 107 is then placed proximate thepectorally implanted medical device. For a pectorally implanted medicaldevice on the patient's right side, the main buckle is the connectionbetween the buckle portion 263 of the charging unit holder 260 and thebuckle portion 257 of the left chest strap 252 and serves as the mainbuckle the patient uses to secure and release the holster 215. For apectorally implanted medical device on the patient's left side, the mainbuckle is the connection between the buckle portion 262 of the chargingunit holder 260 and the buckle portion 254 of the right chest strap 268and serves as the main buckle the patient uses to secure and release theholster 215. The shoulder strap 235 and the chest straps 252 and 268 maybe adjusted using the adjusters 253 as needed to ensure that the antenna107 is proximate the pectorally implanted medical device.

Another embodiment holster 315 is shown in FIG. 19. The holster 315includes an antenna holder 316, a shoulder strap 335, a chest strap 352,and a charging unit holder 360. The antenna holder 316 is preferablyconstructed similarly to the antenna holders 116 and 216 and isconfigured and arranged to house an antenna 107.

The shoulder strap 335 includes a first end 335 a, a second end 335 b,and an intermediate portion 335 c between the first end 335 a and thesecond end 335 b. The first end 335 a is connected to a top portion 325of the antenna holder 316, and the second end 335 b is connected to anadjuster 353. The intermediate portion 335 c of the shoulder strap 335is routed through slots in the adjuster 353 and through a slot of aconnector 348, which connects the intermediate portion 335 c to ajunction 340. To adjust the length of the shoulder strap 335, theadjuster 353 and the second end 335 b may be moved along the length ofthe intermediate portion 335 c by sliding the intermediate portion 335 cthrough the slots of the adjuster 353 and the connector 348. Theadjuster 353 preferably does not come into contact with the patient'sskin to aid in the comfort of the holster 315.

The junction 340 is preferably an upside down T-shaped memberinterconnecting the shoulder strap 335 and the chest strap 352 andincluding a top portion 341 and a bottom portion 347. An opening 350 isformed between the shoulder strap 335 and the chest strap 352 throughwhich the patient's arm is inserted to don the holster 315. Theconnector 348 interconnects the shoulder strap 335 and the top portion341. The bottom portion 347 includes a left portion 342, a right portion343, and a channel 346 extending through the bottom portion 347. Thechannel 346 is preferably wide enough to accommodate the chest strap 352and slide the chest strap 352, including an adjuster 353, therethrough.

The chest strap 352 includes a first end 352 a, a second end 352 b, anintermediate portion 352 c between the first end 352 a and the secondend 352 b, and an optional extension portion 352 d. The first end 352 ais connected to the right side 327 of the antenna holder 316 and thesecond end 352 b is connected to an adjuster 353 in a similar manner asthe second end 335 b of the shoulder strap 335 is connected to anadjuster 353. One end of the extension portion 352 d is connected to theleft side 326 of the antenna holder 316 and the other end is connectedto a buckle portion 363. The extension portion 352 d is optional as thebuckle portion 363 could be connected to the left side 326 of theantenna holder 316. The intermediate portion 352 c is routed throughslots (not shown) of the adjuster 353 and through a slot (not shown) ofa buckle portion 357. The buckle portions 363 and 357 are mating buckleportions. To adjust the length of the chest strap 352, the adjuster 353and the second end 352 b may be moved along the length of theintermediate portion 352 c by sliding the intermediate portion 352 cthrough the slots of the adjuster 353 and the buckle portion 357.

The charging unit holder 360 is preferably constructed similarly to thecharging unit holders 160 and 260 and is configured and arranged tohouse a charging unit but does not include a strap with bucklesconnected to the back. Rather, a fastener (not shown) is preferablyconnected to the back and is configured and arranged to be releasablyconnected to a mating fastener (not shown) connected to the chest strap352 or to the shoulder strap 335. These mating fasteners are preferablyhook and loop, snaps, or other suitable mating fasteners that wouldallow the charging unit holder 360 to be releasably connected to thechest strap 352 or to the shoulder strap 335. The charging unit holder360 may be positioned and repositioned at any suitable location alongthe length of the chest strap 352 or the shoulder strap. Alternatively,the charging unit holder 360 may be placed in the patient's pocket,around the patient's waist using a waist belt, or any other suitablelocation.

The holster 315 is versatile as it may be donned in a firstconfiguration on the patient's right side as illustrated in FIG. 19 orit may be donned in a second configuration on the patient's left side.The shoulder strap 335 may be placed on either the right or the leftshoulder of the patient, and the charging unit holder 360 may bepositioned anywhere along the length of the chest strap 352 or theshoulder strap 335.

To don the holster 315, it is first determined on which side of thepatient the pectorally implanted medical device is located, and then theholster 315 is configured accordingly. Then, the patient inserts thepatient's arm through the shoulder strap 335 and through the opening 350between the shoulder strap 335 and the chest strap 352. The buckleportions 363 and 357 are then connected. After the pectorally implantedmedical device 103 has been located, the antenna 107 is then placedproximate the pectorally implanted medical device 103. The shoulderstrap 335 and the chest strap 352 may be adjusted using the adjusters353 as needed to ensure that the antenna 107 is proximate the pectorallyimplanted medical device 103. For a shorter charge time of thepectorally implanted medical device 103, the center of the antenna 107should be placed over the center of the pectorally implanted medicaldevice 103. The antenna 107 should not be moved around or the chargetime could be increased. Also, the less tissue there is between thepectorally implanted medical device 103 and the antenna 107, the shorterthe charge time will be.

Another embodiment holster 415 is shown in FIGS. 20-29. The holster 415includes an antenna holder 416, a shoulder strap 435, and a torso strap452. An optional charging unit holder 480 may be used with the holster415.

The antenna holder 416 is preferably constructed similarly to theantenna holders 116, 216, and 316 and is configured and arranged tohouse an antenna 407 including a raised portion 407 a and a contactportion (not shown). The antenna holder 416 includes a first panel 417and a second panel 419 preferably interconnected by stitching (notshown) around the edges of the panels 417 and 419. The panels 417 and419 proximate the top of the antenna holder 416 are preferably not sewntogether to allow access to a cavity 422 between the panels 417 and 419and are releasably connected with a fastener (not shown) such as but notlimited to hook and loop or a snap. The first panel 417 includes arounded center portion 423, a top portion 425, and a bottom portion (notshown) corresponding with a rounded center portion 424, a top portion428, and a bottom portion 429 of the second panel 419. The centerportion 423 includes an opening 418 and the center portion 424 includesan opening 420. The antenna 407 is housed within the cavity 422 betweenthe first and second panels 417 and 419 proximate the center portions423 and 424. The center portions 423 and 424 correspond with the shapeof the antenna 407 and are configured and arranged to receive theantenna 407. The shape of the center portions 423 and 424 assist inkeeping the antenna 407 positioned properly within the antenna holder416. The opening 418 is configured and arranged to expose the contactportion (not shown) and the opening 420 is configured and arranged toaccommodate the raised portion 407 a, which extends through the opening420 to also assist in keeping the antenna 407 positioned properly withinthe antenna holder 416. Preferably, the opening 420 is larger than theopening 418. Stitching 421 is configured and arranged to hold aretaining member (not shown) in place proximate the opening 420. Theretaining member is preferably a plastic ring member configured andarranged to accommodate the raised portion 407 a to assist in keepingthe raised portion 407 a in place within the opening 420.

Proximate the bottom portions, a strap 434 is operatively connected tothe antenna holder 416, preferably with stitching (not shown). The strap434 is threaded through slots in a male buckle portion 433, which isslidably connected to the strap 434. Proximate the top portions 425 and428, a connector 432 interconnects the antenna holder 416 to theshoulder strap 435. The shoulder strap 435 includes a first end 435 a, asecond end 435 b, and an intermediate portion 435 c between the firstend 435 a and the second end 435 b. The first end 435 a is operativelyconnected to an intermediate portion 452 c of the torso strap 452,preferably with stitching 457. The second end 435 b is operativelyconnected to an adjuster 436. The intermediate portion 435 c of theshoulder strap 435 is routed through slots in the adjuster 436 andthrough a slot of the connector 432, which connects the intermediateportion 435 c to the top portions 425 and 428 of the antenna holder 416.The adjuster 436 may be slid along the intermediate portion 435 c toadjust the length of the shoulder strap 435. The adjuster 436 preferablydoes not come into contact with the patient's skin to aid in the comfortof the holster 415. Although the strap 434 is preferably a separatestrap from the shoulder strap 435, the strap 434 may be considered anextension of the shoulder strap 435 functioning as a connecting strapinterconnecting the shoulder strap 435 and the torso strap 452.

The torso strap 452 includes a first end 452 a, a second end 452 b, anintermediate portion 452 c between the first end 452 a and the secondend 452 b, and an optional elastic portion 452 d of the intermediateportion 452 c. The first end 452 a is routed through slots in a malebuckle portion 454 and the second end 452 b is connected to a femalebuckle portion 455, which mates with the male buckle portion 454.

A first connector 460 includes a strap 461, a female buckle portion 462,and an optional hook member 463. The strap 461 is routed through a slotin the female buckle portion 462, folded back onto itself, and thenconnected to the hook member 463. Thus, the strap 461 includes twolayers between the female buckle portion 462 and the hook member 463through which the torso strap 452 is routed so that the first connector460 is positioned on the intermediate portion 452 c between the shoulderstrap 435 and the first end 452 a and may be slid along the intermediateportion 452 c. A second connector 465 includes a strap 466, a femalebuckle portion 467, and an optional hook member 468. The strap 466 isrouted through a slot in the female buckle portion 467, folded back ontoitself, and then connected to the hook member 468. Thus, the strap 466includes two layers between the female buckle portion 467 and the hookmember 468 through which the torso strap 452 is routed so that thesecond connector 465 is positioned on the intermediate portion 452 cbetween the shoulder strap 435 and the second end 452 b and may be slidalong the intermediate portion 452 c. The female buckle portions 462 and467 are configured and arranged to mate with the male buckle portion433.

Preferably, the straps of the holster 415 are made of a nylon or apolyester material. Portions of the straps of the holster 415 may bemade of an elastic material to enhance the comfort of donning theholster 415. For example, the strap 434 may be elastic, the portion 452d of the intermediate portion 452 c may be elastic, and the straps 461and 466 may be elastic.

The optional charging unit holder 480 is configured and arranged tohouse the charging unit 409. The charging unit holder 480 is shown inFIGS. 30 and 31. The optional charging unit holder 480 may be used as aprotective sleeve for the charging unit 409 and may be used as a meansfor connecting the charging unit 409 to a connecting structure such asbut not limited to the holster 415, a belt, a pocket, the patient'sclothing, or any other suitable connecting structure. The front of thecharging unit holder 480 includes a viewing window 487 proximate the topto allow the screen of the charging unit 409 to be viewed and a window488 below the viewing window 487 to allow access to the buttons on thecharging unit 409. A releasable flap 489 proximate the top of thecharging unit holder 480 allows the charging unit 409 to be securedwithin and removed from the charging unit holder 480. A fastener (notshown), such as but not limited to hook and loop or a snap, is used toreleasably connect the flap 489 to the rear of the charging unit holder480.

The rear of the charging unit holder 480, shown in FIG. 31, may includea suitable connector for connecting the charging unit holder 480 to theconnecting structure. An example of a suitable connector is a ring 481connected proximate the bottom of the charging unit holder 480. The ring481 may be connected to either of the hook members 463 and 468 of theholster 415, preferably with the front of the charging unit holder 480facing away from the patient. To view the screen of the charging unit409, the charging unit holder 480 is simply pivoted upward toward thepatient so that the front of the charging unit holder 480 faces thepatient. Another example of a suitable connector is a first slot 482 anda second slot 483 proximate the middle of the charging unit holder 480.The torso strap 452 or the shoulder strap 435 of the holster 415, abelt, or any other suitable elongate member may be threaded through theslots 482 and 483 to connect the charging unit holder 480 to the holster415, the belt, or the other suitable elongate member. Another example ofa suitable connector is a clip 484 that may be slid onto any suitableconnecting structure. A side view of the clip 484 is shown in FIG. 32.The charging unit holder 480 may be connected, disconnected, andreconnected to any suitable connecting structure. Alternatively, thecharging unit holder 480 or the charging unit 409 may be placed in thepatient's pocket or even hand-held.

The holster 415 is versatile as it may be donned in a firstconfiguration on the patient's right side as illustrated in FIG. 28 orit may be donned in a second configuration on the patient's left side asillustrated in FIG. 29. FIG. 21 shows a patient 400 with a pectoralimplant 403 located proximate the patient's right pectoral region. Howthe holster 415 is configured to be donned on the patient's right sideis illustrated in FIGS. 21-28. First, the male buckle portion 433 isconnected to the female buckle portion 462 as shown in FIGS. 21 and 22forming a loop with an opening through which the patient's right arm isinserted as shown in FIG. 23. The shoulder strap 435 is placed on thepatient's right shoulder as shown in FIG. 24. Then, the torso strap 452is positioned about the patient's torso and the male buckle portion 454is connected to the female buckle portion 455 as shown in FIG. 25. Thetorso strap 452 may be tightened about the patient's torso by pulling onthe torso strap 452 proximate the first end 452 a thus sliding the torsostrap 452 through the slots in the male buckle portion 454 as shown inFIG. 26.

After the pectorally implanted medical device 403 has been located, theantenna holder 416 is positioned proximate the pectorally implantedmedical device 403. The shoulder strap 435, the torso strap 452, and thestrap 461 may be adjusted as needed to ensure that the antenna holder416 is proximate the pectorally implanted medical device 403.Preferably, to optimize the charge and to reduce the charge time, theopening 418 exposing the contact portion of the antenna 407 shouldcorrespond with the location of the pectorally implanted medical device403. For a shorter charge time of the pectorally implanted medicaldevice 403, the center of the antenna 407 should be placed over thecenter of the pectorally implanted medical device 403. The antenna 407should not be moved around or the charge time could be increased. Also,the less tissue there is between the pectorally implanted medical device403 and the antenna 407, the shorter the charge time will be.

To adjust the length of the torso strap 452, the first end 452 a and theintermediate portion 452 c proximate the first end 452 a is slid throughthe slots in the male buckle portion 454. The torso strap 452 may beraised and lowered on the patient's torso, including the chest and thewaist, so the patient can position the holster 415 where it is mostcomfortable. To adjust the length between the top portions 425 and 428of the antenna holder 416 and the torso strap 452, the adjuster 436 andthe second end 435 b are moved along the length of the intermediateportion 435 c by sliding the intermediate portion 435 c through theslots of the adjuster 436 and the connector 432. To adjust the lengthbetween the bottom portions of the antenna holder 416 and the torsostrap 452, the strap 434 is slid through the slots in the male buckleportion 433. The strap 461 may also be adjusted by simply sliding it tothe desired location on the intermediate portion 452 c.

The antenna 407 is then placed within the cavity 422 of the antennaholder 416 by separating the first and second panels 417 and 419,inserting the antenna 407 between the panels 417 and 419, andpositioning the raised portion 407 a of the antenna 407 so that itextends through the opening 420. This is shown in FIG. 27. The first andsecond panels 417 and 419 are then connected to secure the antenna 407within the antenna holder 416.

If the pectoral implant 403 is located proximate the patient's leftpectoral region, the male buckle portion 433 is connected to the femalebuckle portion 467. The holster 415 is then configured to be donnedproximate the patient's left side similarly as described with respectthe patient's right side. The holster 415 is shown donned on thepatient's left side in FIG. 29.

FIGS. 28 and 29 show the patient holding the charging unit 409 connectedto the antenna 407 with a cable 408. The charging unit 409 may be placedin a pocket or in the charging unit holder 480 and connected to aconnecting structure.

Holsters 115, 215, 315, and 415 are reversible and adjustable so thatthey may be used to accommodate most all patients with pectorallyimplanted medical devices. The features of the holsters 115, 215, 315,and 415 may be interchanged among the embodiments. Holsters 115, 215,315, and 415 may be made of any suitable material and are preferablymade of a breathable material and may even be made of an elasticmaterial or a moisture wicking material.

The above specification, examples and data provide a completedescription of the manufacture and use of the composition of thedisclosed aspects. Since many embodiments of the disclosed aspects canbe made without departing from the spirit and scope of the disclosure,the invention resides in the claims hereinafter appended.

1. A system to transcutaneously charge a power supply of an implantabledevice adapted to be implanted in a patient, comprising: a chargingunit; an antenna coupled to the charging unit; a strap comprising ashoulder strap portion adapted to be supported by the shoulder of thepatient and a second strap portion adapted to encircle a portion of thepatient; and a cavity carried by the strap and being positionable to alocation proximate the implantable device, the cavity adapted to receivethe antenna.
 2. The system of claim 1, wherein the second strap portionis adapted to receive the chest of the patient.
 3. The system of claim1, wherein the second strap portion is adapted to receive the waist ofthe patient.
 4. The system of claim 1, wherein the shoulder strapportion is removable.
 5. The system of claim 1, wherein at least one ofthe shoulder strap portion and the second strap portion is adjustable.6. The system of claim 1, further comprising an antenna holdercomprising the cavity, a top, a first side, and a second side, whereinthe second strap portion further comprises a first end, a second end,and an intermediate portion, and wherein the shoulder strap portion hasa third end and a fourth end, the first end being operatively connectedto the first side of the antenna holder, the second end being releasablyconnectable to the second side of the antenna holder, the third endbeing operatively connected to the top of the antenna holder and thefourth end being operatively connected to the intermediate portion ofthe second strap portion.
 7. The system of claim 1, further comprisingan antenna holder comprising the cavity, a top, a bottom, and first andsecond sides, wherein the second strap portion further comprises a firstend, a second end, and an intermediate portion, and wherein the shoulderstrap portion comprises a third end and a fourth end, the top beingoperatively connected to the third end, the bottom being releasablyconnectable to the intermediate portion, the fourth end beingoperatively connected to the intermediate portion, and the first andsecond ends being releasably connectable.
 8. The system of claim 1,further comprising a charging unit holder adapted to receive thecharging unit.
 9. The system of claim 8, wherein the charging unitholder may be positioned anywhere along the shoulder strap portion oranywhere along the second strap portion.
 10. The system of claim 1,further comprising the implantable medical device.
 11. The system ofclaim 1, further comprising an antenna holder providing the cavity, andwherein the antenna holder is adapted to keep the antenna in apredetermined position within the cavity.
 12. The system of claim 1,further comprising an antenna holder comprising the cavity and anopening to allow access to at least a portion of the antenna when theantenna is positioned within the cavity.
 13. The system of claim 1,further comprising an antenna holder comprising the cavity and anopening to allow a portion of the antenna to be positioned in relativelyclose proximity to a portion of the patient.
 14. The system of claim 1,further comprising an antenna holder comprising the cavity and anopening adapted to accommodate a predetermined portion of the antenna.15. The system of claim 1, wherein the charging unit comprises arechargeable power source.
 16. A system, comprising: a charging unit; anantenna coupled to the charging unit; an implantable device adapted toreceive energy from the charging unit; a strap comprising a shoulderstrap portion adapted to be supported by the shoulder of the patient;and a cavity carried by the strap and being positionable to a locationproximate the implantable device, the cavity adapted to receive theantenna.
 17. The system of claim 16, further comprising a second strapportion adapted to receive the chest of the patient.
 18. The system ofclaim 16, further comprising a second strap portion adapted to receivethe waist of the patient.
 19. The system of claim 16, wherein theshoulder strap portion is adjustable.
 20. The system of claim 16,further comprising an antenna holder comprising a top and the cavity,wherein the shoulder strap portion further comprises an end operativelyconnected to the top of the antenna holder.
 21. The system of claim 20,further comprising a second strap portion comprising a first end and asecond end, and wherein the antenna holder further comprises a firstside connected to the first end of the second strap portion and a secondside connected to the second end of the second strap portion.
 22. Thesystem of claim 20, further comprising a second strap portion, andwherein the shoulder strap portion is slidably positionable relative tothe second strap portion.
 23. The system of claim 20, further comprisinga second strap portion comprising a first end, a second end, and anintermediate portion extending there between, and wherein the shoulderstrap portion further comprises another end operatively connected to theintermediate portion.
 24. The system of claim 16, further comprising acharging unit holder adapted to receive the charging unit.
 25. Thesystem of claim 24, wherein the charging unit holder may be positionedanywhere along the shoulder strap portion.
 26. The system of claim 16,further comprising an antenna holder comprising the cavity, and whereinthe antenna holder is adapted to maintain the antenna in a predeterminedposition within the cavity.
 27. The system of claim 16, furthercomprising an antenna holder comprising the cavity and an opening toallow access to a portion of the antenna when the antenna is positionedwithin the cavity.
 28. The system of claim 16, further comprising anantenna holder comprising the cavity and an opening to allow at least aportion of the antenna to be placed in proximity to a portion of thepatient's body.
 29. The system of claim 16, further comprising anantenna holder comprising the cavity and an opening adapted to receive apredetermined raised portion of the antenna.
 30. A system, comprising:an implantable device adapted to be implanted in a patient; a chargingunit; an antenna coupled to charging unit; and a strap adapted to besupported by a portion of the patient's body, the strap comprising acavity adapted to carry the antenna to allow the antenna totranscutaneously provide energy to the implantable device.
 31. Thesystem of claim 30, wherein the strap is adapted to allow the cavity tobe positionable relative to the implantable device.